Forging International Partnerships at the School of Nursing

Visiting nurse researchers with Professor LeRae Galarowicz

Recently, the UW-Madison School of Nursing (SoN) community welcomed the opportunity to promote the Wisconsin Idea--internationally. During the week of August 15, 2004, the SoN hosted three Japanese visitors, whose aim was to lay the groundwork for forging an international partnership with SoN.

Professor Ikuko Miyabayashi, from the Japanese Red Cross Kyushu International College of Nursing; Miyuki Adachi, assistant professor and researcher at Gifu University School of Medicine; and Tomoe Yoshimochi, assistant head of nursing at Tottori University Teaching Hospital came to the school to discuss the formation of a formal exchange program and the teaching of nursing ethics to students and clinicians.

Why UW-Madison?

Why Wisconsin and why the UW-Madison School of Nursing? The three nurse researchers had targeted the SoN because of Miyabayashi’s connection to the UW. In 1990, Miyabayashi received her bachelor’s in nursing from SoN (at that time, her last name was Yano-Miyabayashi). Therefore, when the president of her college, Dr. Michiyo Kojima, RN, PhD, recently asked that Miyabayashi travel to the United States to explore development of an exchange program, Miyabayashi decided to reconnect her ties with UW-Madison.

Miyabayashi’s charge was this: to explore possibilities of joint research and student exchange with SoN faculty members. From this international collaboration, Japan’s nursing leadership anticipates the development of a strong graduate program at Kyushu International College of Nursing—an institution whose origins are rooted in The Japanese Red Cross.

Examining Nursing Ethics: Education and Practice

Education

Adachi and Yoshimochi accompanied Miyabayashi to UW-Madison with hopes of cultivating discourse and gathering perspectives on nursing ethics. Adachi is researching the necessity of ethical education for nurses in clinical practice. She is interested in examining ethical sensitivity—which she defines as an ability that a nurse should possess when judging ethical issues.

It is Adachi’s hypothesis that sensitivity to ethical issues can be influenced by a variety of factors: culture, ethics of a group or occupation, experience, education and religion (see “A Study Progress Report”). Her research targets the education factor.

Re-emphasizing that nursing ethics must be built on a strong foundation of education, Miyabayashi hopes to introduce nursing ethics as an independent entity in nursing education and continuing nursing education. Adding nursing ethics to the curriculum requires authorization by a governing body similar to the American Association of Colleges of Nursing and then by the Japanese government.

Practice

Yoshimochi plays a supportive role in Adachi’s research and presentations on nursing ethics, sharing her experiences as a critical care nurse on ethical decision making. She recalled a situation where a patient experiencing liver failure was rushed to the hospital by ambulance. The patient wanted medication to leverage the pain, but family members refused to allow him medication for fear that analgesics would dull his ability to communicate.

Scenarios such as this have prompted discussions in Japan’s nursing practice about patients’ limited rights when deciding their health options. Too often, primary decision making is made by the family members of the patient—a situation that must be changed, according to Miyabayashi.

“In the United States,” said Miyabayashi, “the patient is the main decision maker, but in Japan, a family member makes the decision on health issues”—a situation rife with ethical implications.

Adachi, in her published research, titled “The Necessity of Ethical Education for Clinical Nurses in Japan,” noted that subjects such as death with dignity, informed consent; and brain death/organ transplantation, give rise to ethical dilemmas regarding patients’ rights, the patient-doctor relationship, and lack of physician explanation about patient’s health status.

Building the Connection

The week’s activities for the three visitors, orchestrated by Clinical Professor LeaRae Galarowicz, proved fruitful. Activities included meetings with Linda Baumann, professor of nursing; Nadine Nehls, associate dean for academic programs; Sharon Nellis, assistant dean for academic affairs and outreach; and Rita Vosters, clinical associate professor.

Discussions with SoN faculty included the teaching of ethics in clinical courses, course content and evaluation, the logistics of a program exchange, and, in particular, methods for awakening sensitivity in nursing education.

Although Tomoe and Adachi’s first trip to the U.S. some years ago provided the ultimate in entertainment—a visit to the Magic Kingdom at Disneyworld-Orlando—this second trip to the United States by way of Madison, Wis., proved to be far more rewarding.

To contact any of the three Japanese visitors, see e-mails below:

Miyuki Adachi, RN, MA (adachim@cc.gifu-u.ac.jp )
Ikuko Miyabayashi, RN, MS (i-miyabayashi@jrckicn.ac.jp )
Tomoe Yoshimochi, RN (patoral7@oregano.ocn.ne.jp )